Organization
VLP INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICTORIJA L PEISTRUP MD (OWNER)
(207) 743-1562
Entity
Organization
Contact information
Practice address
181 MAIN ST, NORWAY, ME 04268-5664
(207) 743-1562
Mailing address
PO BOX 790056, SAINT LOUIS, MO 63179-0056
(314) 989-0300
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
016515
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11213865
PEISTRUP-CAQH
ME
Enumeration date
04/07/2006
Last updated
08/22/2020
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